Individual provider Active NPI

Mary Alice Fulmer, DNP, ARNP, FNP-C

  • Family Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1124563176
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9331488 Issued in FL
Practice address
111 N Orange Ave Ste 800
Orlando, FL 32801-2381
Phone
(888) 731-8994
NPI assigned
Dec 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9331488 FL Primary

Addresses

Primary practice location

111 N Orange Ave Ste 800
Orlando, FL 32801-2381

Mailing address

111 N Orange Ave Ste 800
Orlando, FL 32801-2381

Other practice location 1

9700 S Dixie Hwy Ste 1060
Miami, FL 33156-2870
Phone (786) 453-0332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9331488FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalmd Group Holding LLC Past Accepting new patients
Integrative Womens Care PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mary.alice.fulmer.1@27069.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1482969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1124563176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N ORANGE AVE STE 800",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328012381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N ORANGE AVE STE 800",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328012381",
            "telephone_number": "888-731-8994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9700 S Dixie Hwy Ste 1060",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331562870",
            "country_code": "US",
            "telephone_number": "786-453-0332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULMER",
        "first_name": "MARY",
        "middle_name": "ALICE",
        "credential": "DNP, ARNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-29",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9331488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.